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Organization

DAVID EVDOKIMOW, M.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID Z EVDOKIMOW M.D. (PRESIDENT)
(908) 221-1136
Entity
Organization

Contact information

Practice address
96 SOUTH FINLEY AVE., BASKING RIDGE, NJ 07920
(908) 221-0482
(908) 221-0482
Mailing address
96 SOUTH FINLEY AVE., BASKING RIDGE, NJ 07920
(908) 221-0482
(908) 221-0482

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
207NS0135X
Procedural Dermatology Physician
208600000X
Surgery Physician
2086S0105X
Surgery of the Hand (Surgery) Physician
2086S0120X
Pediatric Surgery Physician
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
208D00000X
General Practice Physician

Other

Enumeration date
06/13/2013
Last updated
06/13/2013
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